Olgu Sunumu
BibTex RIS Kaynak Göster

Serebellopontin iskeminin semptomu olarak izole trigeminal nevralji: bir olgu sunumu

Yıl 2024, , 47 - 49, 31.01.2024
https://doi.org/10.55665/troiamedj.1305000

Öz

Trigeminal Nevralji (TN) karakteristik olarak trigeminal sinir ve dallarının bölgesinde tek taraflı tekrarlayan şok benzeri ağrı olarak kendini gösterir. Ponsta trigeminal kök giriş bölgesinin iskemik lezyonuna bağlı sekonder TN çok nadirdir. Burada merkezi trigeminal yolları kesen ve izole trigeminal nevralji ile sonuçlanan serebellopontin enfarktı olan bir olguyu sunuyoruz. Yetmiş iki yaşında erkek hasta, 20 gün önce aniden başlayan ve son iki gündür sıklığı artan yüzünün sol tarafında 3-5 saniye süren uyuşma ve tekrarlayan şok benzeri ağrı atakları ile acil servisimize başvurdu. Nörolojik muayenede sol maksiller trigeminal sinir dermatomunda dokunmaya karşı hafif hipoestezi saptandı. İlk incelemede, Difüzyon Ağırlıklı Manyetik Rezonans Görüntüleme (MRG), Görünür Difüzyon Katsayısı'nda (ADC) hipointensite olmadan, sol trigeminal sinirin kök giriş bölgesi olan pons ve sol inferior serebellar pedinkül bileşkesinde hiperintensite gösterdi. Kontrastsız Bilgisayarlı Tomografide (BT) aynı bölgede hipodensite saptandı. Başvurudan sonra MRG, lezyonun subakut enfarkt ile uyumlu, T1-hipointintens, T2-hiperintens, minimal heterojen IV gadolinyum-kontrast tutulumu gösterdiği belirlendi. Ponstaki trigeminal kök giriş bölgesinin iskemik lezyonuna atfedilen başka herhangi bir anormal nörolojik belirti olmaksızın sekonder TN olağann dışıdır, ancak imkansız değildir ve karbamazepin tedavisine iyi yanıt verir. TN ile başvuran hastalar, olası ikincil sorunları belirlemek için kapsamlı bir incelemeden geçmelidir.

Proje Numarası

1

Kaynakça

  • 1. Headache Classification Committee of the In-ternational Headache Society (IHS) The International Classification of Headache Disorders, 3rd edition. Cep-halalgia 2018;38: 1–211
  • 2. Maarbjerg, S., Di Stefano, G., Bendtsen, L. & Cruccu, G. Trigeminal neuralgia – diagnosis and treat-ment. ;2017:37: 648–657.
  • 3. Maarbjerg, S., Gozalov, A., Olesen, J. & Bendtsen, L. Trigeminal Neuralgia - A Prospective Sys-tematic Study of Clinical Characteristics in 158 Patients. Headache J. Head Face Pain 2014; 54: 1574–1582
  • 4. Nomura, T., Ikezaki, K., Matsushima, T. & Fukui, M. Trigeminal neuralgia: Differentiation between intrac-ranial mass lesions and ordinary vascular compression as causative lesions. Neurosurg. Rev;1994:17: 51–57
  • 5. Cabral, G., Lorga, T., Caetano, A., Baptista, T. & Baptista, M. V. Secondary Trigeminal Neuralgia: Do Not Forget the Pontine Ischemic Infarction. Eur. Neurol. 2021;84: 391–392
  • 6. Katsuno, M. & Teramoto, A. Secondary Trigemi-nal Neuropathy and Neuralgia Resulting from Pontine Infarction. J. Stroke Cerebrovasc. Dis.2010;19: 251–252
  • 7. Peker, S., Akansel, G., Sun, I. & Pamir, N. M. Trigeminal Neuralgia Due to Pontine Infarction. Headac-he 2004; 44: 1043–1055
  • 8. Cruccu, G. et al. AAN-EFNS guidelines on trigeminal neuralgia management. Eur. J. Neurol.2008;15: 1013–1028.

Isolated trigeminal neuralgia as the presenting symptom of cerebellopontine infarction: a case report

Yıl 2024, , 47 - 49, 31.01.2024
https://doi.org/10.55665/troiamedj.1305000

Öz

Trigeminal Neuralgia (TN) characteristically presents as unilateral recurring shock-like pain in the trajectory of the trigeminal nerve and its branches. Secondary TN is rare due to an ischemic lesion of the trigeminal root entry zone in pons. Here we report a patient with a cerebellopontine infarction transecting the central trigeminal pathways, resulting in isolated trigeminal neuralgia. A 72-year-old male patient presented to our emergency department with numbness and recurrent shock-like pain attacks on the left side of his face lasting 3 to 5 seconds starting abruptly 20 days ago and increasing in frequency in the last two days.
Neurologic examination revealed slight hypoesthesia to touch on the left maxillary trigeminal nerve dermatome. There was no other abnormality in the neurological examination. In the initial work-up, Diffusion-Weighted Magnetic Resonance Imaging (MRI) showed hyperintensity on the junction of the pons and left inferior cerebellar peduncle, the root-entry-zone of the left trigeminal nerve, without hypointensity in Apparent Diffusion Coefficient (ADC) sequence. Noncontrasted Computer Tomography (CT) revealed hypodensity in the same region. After the admission, an MRI showed the lesion was T1-hypointense, T2-hyperintense, minimally heterogeneously IV gadolinium-contrast enhancing, consistent with subacute infarction.
Secondary TN without any other abnormal neurologic signs attributed to an ischemic lesion of the trigeminal root entry zone in pons is unusual, but not impossible, and responds well to carbamazepine treatment. Patients who present with TN should undergo a comprehensive work-up to identify probable secondary matters.

Destekleyen Kurum

Conflict of interest: There is no conflict of interest. Fundation: No subsidies or grants has contributed to the work.

Proje Numarası

1

Teşekkür

We, authors, kindly ask you to review our manuscript.. This manuscript complies with all instructions to authors, and the final manuscript was approved by all authors. We also would like to point out that this manuscript has not been published and is not under consideration by another journal

Kaynakça

  • 1. Headache Classification Committee of the In-ternational Headache Society (IHS) The International Classification of Headache Disorders, 3rd edition. Cep-halalgia 2018;38: 1–211
  • 2. Maarbjerg, S., Di Stefano, G., Bendtsen, L. & Cruccu, G. Trigeminal neuralgia – diagnosis and treat-ment. ;2017:37: 648–657.
  • 3. Maarbjerg, S., Gozalov, A., Olesen, J. & Bendtsen, L. Trigeminal Neuralgia - A Prospective Sys-tematic Study of Clinical Characteristics in 158 Patients. Headache J. Head Face Pain 2014; 54: 1574–1582
  • 4. Nomura, T., Ikezaki, K., Matsushima, T. & Fukui, M. Trigeminal neuralgia: Differentiation between intrac-ranial mass lesions and ordinary vascular compression as causative lesions. Neurosurg. Rev;1994:17: 51–57
  • 5. Cabral, G., Lorga, T., Caetano, A., Baptista, T. & Baptista, M. V. Secondary Trigeminal Neuralgia: Do Not Forget the Pontine Ischemic Infarction. Eur. Neurol. 2021;84: 391–392
  • 6. Katsuno, M. & Teramoto, A. Secondary Trigemi-nal Neuropathy and Neuralgia Resulting from Pontine Infarction. J. Stroke Cerebrovasc. Dis.2010;19: 251–252
  • 7. Peker, S., Akansel, G., Sun, I. & Pamir, N. M. Trigeminal Neuralgia Due to Pontine Infarction. Headac-he 2004; 44: 1043–1055
  • 8. Cruccu, G. et al. AAN-EFNS guidelines on trigeminal neuralgia management. Eur. J. Neurol.2008;15: 1013–1028.
Toplam 8 adet kaynakça vardır.

Ayrıntılar

Birincil Dil İngilizce
Konular Klinik Tıp Bilimleri (Diğer)
Bölüm Makaleler
Yazarlar

Aslı Sena Kaya 0009-0005-5954-7478

Bekir Burak Kılboz 0000-0002-4014-0425

Canan Bolcu Emir 0000-0002-5418-930X

Proje Numarası 1
Yayımlanma Tarihi 31 Ocak 2024
Gönderilme Tarihi 28 Mayıs 2023
Yayımlandığı Sayı Yıl 2024

Kaynak Göster

APA Kaya, A. S., Kılboz, B. B., & Bolcu Emir, C. (2024). Isolated trigeminal neuralgia as the presenting symptom of cerebellopontine infarction: a case report. Troia Medical Journal, 5(1), 47-49. https://doi.org/10.55665/troiamedj.1305000
AMA Kaya AS, Kılboz BB, Bolcu Emir C. Isolated trigeminal neuralgia as the presenting symptom of cerebellopontine infarction: a case report. Troia Med J. Ocak 2024;5(1):47-49. doi:10.55665/troiamedj.1305000
Chicago Kaya, Aslı Sena, Bekir Burak Kılboz, ve Canan Bolcu Emir. “Isolated Trigeminal Neuralgia As the Presenting Symptom of Cerebellopontine Infarction: A Case Report”. Troia Medical Journal 5, sy. 1 (Ocak 2024): 47-49. https://doi.org/10.55665/troiamedj.1305000.
EndNote Kaya AS, Kılboz BB, Bolcu Emir C (01 Ocak 2024) Isolated trigeminal neuralgia as the presenting symptom of cerebellopontine infarction: a case report. Troia Medical Journal 5 1 47–49.
IEEE A. S. Kaya, B. B. Kılboz, ve C. Bolcu Emir, “Isolated trigeminal neuralgia as the presenting symptom of cerebellopontine infarction: a case report”, Troia Med J, c. 5, sy. 1, ss. 47–49, 2024, doi: 10.55665/troiamedj.1305000.
ISNAD Kaya, Aslı Sena vd. “Isolated Trigeminal Neuralgia As the Presenting Symptom of Cerebellopontine Infarction: A Case Report”. Troia Medical Journal 5/1 (Ocak 2024), 47-49. https://doi.org/10.55665/troiamedj.1305000.
JAMA Kaya AS, Kılboz BB, Bolcu Emir C. Isolated trigeminal neuralgia as the presenting symptom of cerebellopontine infarction: a case report. Troia Med J. 2024;5:47–49.
MLA Kaya, Aslı Sena vd. “Isolated Trigeminal Neuralgia As the Presenting Symptom of Cerebellopontine Infarction: A Case Report”. Troia Medical Journal, c. 5, sy. 1, 2024, ss. 47-49, doi:10.55665/troiamedj.1305000.
Vancouver Kaya AS, Kılboz BB, Bolcu Emir C. Isolated trigeminal neuralgia as the presenting symptom of cerebellopontine infarction: a case report. Troia Med J. 2024;5(1):47-9.